The effect of Huanglian Jiedu Decoction on the intestinal flora of type 2 diabetes mellitus(T2DM) was investigated using 16S rRNA sequencing technology. Sixty rats were randomly divided into a normal group(10 rats) and a modeling group(50 rats). After one week of adaptive feeding, a high-fat diet + streptozotocin was given for modeling, and fasting blood glucose >16.7 mmol·L~(-1) was considered a sign of successful modeling. The modeling group was randomly divided into the model group, high-, medium-, and low-dose groups of Huanglian Jiedu Decoction, and metformin group. After seven days of intragastric treatment, the feces, colon, and pancreatic tissue of each group of rats were collected, and the pathological changes of the colon and pancreatic tissue of each group were observed by hematoxylin-eosin staining. The changes in the intestinal flora structure of each group were observed by the 16S rRNA sequencing method. The results showed that compared with the model group, the high-, medium-, and low-dose of Huanglian Jiedu Decoction reduced fasting blood glucose levels to different degrees and showed no significant changes in body weight. The number of islet cells increased, and intestinal mucosal damage attenuated. Alpha diversity analysis revealed that Huanglian Jiedu Decoction reduced the abundance and diversity of intestinal flora in rats with T2DM; at the phylum level, low-and mediam-dose of Huanglian Jiedu Decoction reduced the abundance of Bacteroidota, Proteobacteria, and Desulfobacterota and increased the abundance of Firmicute and Bacteroidota/Firmicutes, while the high-dose of Huanglian Jiedu Decoction increased the relative abundance of Proteobacteria and Bacteroidota/Firmicutes ratio, and decreaseal the relative; abundance of Firmicute; at the genus level, Huanglian Jiedu Decoction increased the relative abundance of Allobaculum, Blautia, and Lactobacillus; LEfse analysis revealed that the biomarker of low-and medium-dose groups of Huanglian Jiedu Decoction was Lactobacillus, and the structure of the intestinal flora of the low-dose group of Huanglian Jiedu Decoction was highly similar to that of the metformin group. PICRUSt2 function prediction revealed that Huanglian Jiedu Decoction mainly affected carbohydrate and amino acid metabolic pathways. It suggested that Huanglian Jiedu Decoction could reduce fasting blood glucose and increase the number of islet cells in rats with T2DM, and its mechanism of action may be related to increasing the abundance of short-chain fatty acid-producing strains and Lactobacillus and affecting carbohydrate and amino acid metabolic pathways.
Animals ; Drugs, Chinese Herbal/administration & dosage* ; Diabetes Mellitus, Type 2/metabolism* ; Gastrointestinal Microbiome/drug effects* ; Rats ; Male ; Rats, Sprague-Dawley ; Humans ; Bacteria/drug effects* ; Blood Glucose/metabolism*

Objective: To examine the mediating effects of mindfulness level on resilience and symptoms of anxiety and depression among healthcare workers, so as to provide the reference for developing effective psychological intervention. Methods: The clinical doctors, nurses and public health professionals were selected using the stratified random cluster sampling method from hospitals, disease prevention and control centers, and health departments in five cities in Shandong Province, including Qingdao, Jinan, Rizhao, Jining and Liaocheng in January 2023. Basic information, mindfulness level, resilience and symptoms of anxiety and depression among healthcare workers were collected using general demographic questionnaires, the 5-item Mindful Attention Awareness Scale, 10-item Connor-Davidson Resilience Scale, Generalized Anxiety Disorder Scale and Patient Health Questionnaire, respectively. The Process program was used to analyze the mediating effects of mindfulness level on resilience and symptoms of anxiety and depression. Results: A total of 1 836 healthcare workers were investigated, including 472 males (25.71%) and 1 364 females (74.29%), and the median age was 39 (interquartile range, 12) years. There were 629 clinical doctors (34.26%), 963 nurses (52.45%) and 244 public health professionals (13.29%). The median scores of mindfulness level and resilience were 22 (interquartile range, 7) and 20 (interquartile range, 4) points, respectively. The detection rates of anxiety and depression symptoms were 49.78% and 72.28%, respectively. The mediation analysis showed that mindfulness level exerted a partial mediating effect between resilience and anxiety symptoms (β=-0.510, P<0.001), with a direct effect value of -0.130 and a mediating effect value of -0.046, and the mediating effect accounted for 26.14% of the total effect; mindfulness level also exerted a partial mediating effect between resilience and depression symptoms (β=-0.575, P<0.001), with a direct effect value of -0.120 and a mediating effect value of -0.052, and the mediating effect accounted for 30.23% of the total effect. Conclusion Mindfulness level plays a mediating effect between resilience and symptoms of anxiety and depression among healthcare workers.

Objective To understand the respiratory protection competency of staff in hospitals.Methods Staff from six hospitals of different levels and characteristics in Beijing were selected,including doctors,nurses,medical technicians,and servicers,to conduct knowledge assessment on respiratory protection competency.According to exposure risks of respiratory infectious diseases,based on actual cases and daily work scenarios,content of respira-tory protection competency assessment was designed from three aspects:identification of respiratory infectious di-seases,transmission routes and corresponding protection requirements,as well as correct selection and use of masks.The assessment included 6,6,and 8 knowledge points respectively,with 20 knowledge points in total,all of which were choice questions.For multiple-choice questions,full marks,partial marks,and no mark were given respective-ly if all options were correct,partial options were correct and without incorrect options,and partial options were correct but with incorrect options.Difficulty and discrimination analyses on question of each knowledge point was conducted based on classical test theory.Results The respiratory protection competency knowledge assessment for 326 staff members at different risk levels in 6 hospitals showed that concerning the 20 knowledge points,more than 60％participants got full marks for 6 points,while the proportion of full marks for other questions was relatively low.Less than 10％participants got full marks for the following 5 knowledge points:types of airborne diseases,types of droplet-borne diseases,conventional measures for the prevention and control of healthcare-associated infec-tion with respiratory infectious diseases,indications for wearing respirators,and indications for wearing medical protective masks.Among the 20 knowledge questions,5,1,and 14 questions were relatively easy,medium,and difficult,respectively;6,1,4,and 9 questions were with discrimination levels of ≥0.4,0.30-0.39,0.20-0.29,and ≤0.19,respectively.Conclusion There is still much room for hospital staff to improve their respiratory protection competency,especially in the recognition of diseases with different transmission routes and the indications for wearing different types of masks.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

Objective:To explore the clinical application value of magnetic stimulation combined with biofeed-back technology in female stress urinary incontinence(SUI).Methods:Sixty mild or moderate female SUI patients who underwent rehabilitation treatment at the Pelvic Floor Rehabilitation Center of Nanjing Women and Children's Healthcare Hospital from July to December 2021 were collected and randomly divided into two groups,with 30 pa-tients in each group.The observation group received a treatment protocol of electrical stimulation+biofeedback therapy(electric combined group)and the other group received a treatment protocol of magnetic stimulation+bi-ofeedback therapy(magnetic combined group).The treatment course for both groups consisted of 12 sessions.The Sandvik severity Index(urinary incontinence),the amount of u 1-hoururine leakage,pelvic floor muscle strength,pelvic floor muscle electrophysiological indices,the degree of urinary incontinence impact(ⅡQ-7 score)and the treatment efficacy were assessed and compared before and after the treatment in the two groups.Re-sults:Compared with the pre-treatment,the Sandvik Severity Index,the 1-hour urine leakage,and the n Q-7 score decreased in the magnetic combined group and the electric combined group after treatment,while the mus-cle strength of type Ⅰ,type Ⅱ,maximum of fast muscle,and mean value of slow muscle increased significantly,and the differences were statistically significant(P＜0.05).The difference between the above indexes was not statistically significant when comparing the magnetic combined group and the electric combined group after treat-ment(P＞0.05),and the treatment efficiency of the electric combined group was 93.33％and that of the magnet-ic combined group was 96.67％,and there was no statistical significance when comparing the efficiency of the two groups(P＞0.05).Conclusions:Magnetic stimulation combined with biofeedback technology has high thera-peutic efficiency for mild or moderate SUl,and is an optional rehabilitation technique for women with SUI.

Objective:To explore the clinical application value of magnetic stimulation combined with biofeed-back technology in female stress urinary incontinence(SUI).Methods:Sixty mild or moderate female SUI patients who underwent rehabilitation treatment at the Pelvic Floor Rehabilitation Center of Nanjing Women and Children's Healthcare Hospital from July to December 2021 were collected and randomly divided into two groups,with 30 pa-tients in each group.The observation group received a treatment protocol of electrical stimulation+biofeedback therapy(electric combined group)and the other group received a treatment protocol of magnetic stimulation+bi-ofeedback therapy(magnetic combined group).The treatment course for both groups consisted of 12 sessions.The Sandvik severity Index(urinary incontinence),the amount of u 1-hoururine leakage,pelvic floor muscle strength,pelvic floor muscle electrophysiological indices,the degree of urinary incontinence impact(ⅡQ-7 score)and the treatment efficacy were assessed and compared before and after the treatment in the two groups.Re-sults:Compared with the pre-treatment,the Sandvik Severity Index,the 1-hour urine leakage,and the n Q-7 score decreased in the magnetic combined group and the electric combined group after treatment,while the mus-cle strength of type Ⅰ,type Ⅱ,maximum of fast muscle,and mean value of slow muscle increased significantly,and the differences were statistically significant(P＜0.05).The difference between the above indexes was not statistically significant when comparing the magnetic combined group and the electric combined group after treat-ment(P＞0.05),and the treatment efficiency of the electric combined group was 93.33％and that of the magnet-ic combined group was 96.67％,and there was no statistical significance when comparing the efficiency of the two groups(P＞0.05).Conclusions:Magnetic stimulation combined with biofeedback technology has high thera-peutic efficiency for mild or moderate SUl,and is an optional rehabilitation technique for women with SUI.

Objective:To explore the clinical application value of magnetic stimulation combined with biofeed-back technology in female stress urinary incontinence(SUI).Methods:Sixty mild or moderate female SUI patients who underwent rehabilitation treatment at the Pelvic Floor Rehabilitation Center of Nanjing Women and Children's Healthcare Hospital from July to December 2021 were collected and randomly divided into two groups,with 30 pa-tients in each group.The observation group received a treatment protocol of electrical stimulation+biofeedback therapy(electric combined group)and the other group received a treatment protocol of magnetic stimulation+bi-ofeedback therapy(magnetic combined group).The treatment course for both groups consisted of 12 sessions.The Sandvik severity Index(urinary incontinence),the amount of u 1-hoururine leakage,pelvic floor muscle strength,pelvic floor muscle electrophysiological indices,the degree of urinary incontinence impact(ⅡQ-7 score)and the treatment efficacy were assessed and compared before and after the treatment in the two groups.Re-sults:Compared with the pre-treatment,the Sandvik Severity Index,the 1-hour urine leakage,and the n Q-7 score decreased in the magnetic combined group and the electric combined group after treatment,while the mus-cle strength of type Ⅰ,type Ⅱ,maximum of fast muscle,and mean value of slow muscle increased significantly,and the differences were statistically significant(P＜0.05).The difference between the above indexes was not statistically significant when comparing the magnetic combined group and the electric combined group after treat-ment(P＞0.05),and the treatment efficiency of the electric combined group was 93.33％and that of the magnet-ic combined group was 96.67％,and there was no statistical significance when comparing the efficiency of the two groups(P＞0.05).Conclusions:Magnetic stimulation combined with biofeedback technology has high thera-peutic efficiency for mild or moderate SUl,and is an optional rehabilitation technique for women with SUI.

Objective:To explore the clinical application value of magnetic stimulation combined with biofeed-back technology in female stress urinary incontinence(SUI).Methods:Sixty mild or moderate female SUI patients who underwent rehabilitation treatment at the Pelvic Floor Rehabilitation Center of Nanjing Women and Children's Healthcare Hospital from July to December 2021 were collected and randomly divided into two groups,with 30 pa-tients in each group.The observation group received a treatment protocol of electrical stimulation+biofeedback therapy(electric combined group)and the other group received a treatment protocol of magnetic stimulation+bi-ofeedback therapy(magnetic combined group).The treatment course for both groups consisted of 12 sessions.The Sandvik severity Index(urinary incontinence),the amount of u 1-hoururine leakage,pelvic floor muscle strength,pelvic floor muscle electrophysiological indices,the degree of urinary incontinence impact(ⅡQ-7 score)and the treatment efficacy were assessed and compared before and after the treatment in the two groups.Re-sults:Compared with the pre-treatment,the Sandvik Severity Index,the 1-hour urine leakage,and the n Q-7 score decreased in the magnetic combined group and the electric combined group after treatment,while the mus-cle strength of type Ⅰ,type Ⅱ,maximum of fast muscle,and mean value of slow muscle increased significantly,and the differences were statistically significant(P＜0.05).The difference between the above indexes was not statistically significant when comparing the magnetic combined group and the electric combined group after treat-ment(P＞0.05),and the treatment efficiency of the electric combined group was 93.33％and that of the magnet-ic combined group was 96.67％,and there was no statistical significance when comparing the efficiency of the two groups(P＞0.05).Conclusions:Magnetic stimulation combined with biofeedback technology has high thera-peutic efficiency for mild or moderate SUl,and is an optional rehabilitation technique for women with SUI.

Objective:To explore the clinical application value of magnetic stimulation combined with biofeed-back technology in female stress urinary incontinence(SUI).Methods:Sixty mild or moderate female SUI patients who underwent rehabilitation treatment at the Pelvic Floor Rehabilitation Center of Nanjing Women and Children's Healthcare Hospital from July to December 2021 were collected and randomly divided into two groups,with 30 pa-tients in each group.The observation group received a treatment protocol of electrical stimulation+biofeedback therapy(electric combined group)and the other group received a treatment protocol of magnetic stimulation+bi-ofeedback therapy(magnetic combined group).The treatment course for both groups consisted of 12 sessions.The Sandvik severity Index(urinary incontinence),the amount of u 1-hoururine leakage,pelvic floor muscle strength,pelvic floor muscle electrophysiological indices,the degree of urinary incontinence impact(ⅡQ-7 score)and the treatment efficacy were assessed and compared before and after the treatment in the two groups.Re-sults:Compared with the pre-treatment,the Sandvik Severity Index,the 1-hour urine leakage,and the n Q-7 score decreased in the magnetic combined group and the electric combined group after treatment,while the mus-cle strength of type Ⅰ,type Ⅱ,maximum of fast muscle,and mean value of slow muscle increased significantly,and the differences were statistically significant(P＜0.05).The difference between the above indexes was not statistically significant when comparing the magnetic combined group and the electric combined group after treat-ment(P＞0.05),and the treatment efficiency of the electric combined group was 93.33％and that of the magnet-ic combined group was 96.67％,and there was no statistical significance when comparing the efficiency of the two groups(P＞0.05).Conclusions:Magnetic stimulation combined with biofeedback technology has high thera-peutic efficiency for mild or moderate SUl,and is an optional rehabilitation technique for women with SUI.

Objective:To explore the clinical application value of magnetic stimulation combined with biofeed-back technology in female stress urinary incontinence(SUI).Methods:Sixty mild or moderate female SUI patients who underwent rehabilitation treatment at the Pelvic Floor Rehabilitation Center of Nanjing Women and Children's Healthcare Hospital from July to December 2021 were collected and randomly divided into two groups,with 30 pa-tients in each group.The observation group received a treatment protocol of electrical stimulation+biofeedback therapy(electric combined group)and the other group received a treatment protocol of magnetic stimulation+bi-ofeedback therapy(magnetic combined group).The treatment course for both groups consisted of 12 sessions.The Sandvik severity Index(urinary incontinence),the amount of u 1-hoururine leakage,pelvic floor muscle strength,pelvic floor muscle electrophysiological indices,the degree of urinary incontinence impact(ⅡQ-7 score)and the treatment efficacy were assessed and compared before and after the treatment in the two groups.Re-sults:Compared with the pre-treatment,the Sandvik Severity Index,the 1-hour urine leakage,and the n Q-7 score decreased in the magnetic combined group and the electric combined group after treatment,while the mus-cle strength of type Ⅰ,type Ⅱ,maximum of fast muscle,and mean value of slow muscle increased significantly,and the differences were statistically significant(P＜0.05).The difference between the above indexes was not statistically significant when comparing the magnetic combined group and the electric combined group after treat-ment(P＞0.05),and the treatment efficiency of the electric combined group was 93.33％and that of the magnet-ic combined group was 96.67％,and there was no statistical significance when comparing the efficiency of the two groups(P＞0.05).Conclusions:Magnetic stimulation combined with biofeedback technology has high thera-peutic efficiency for mild or moderate SUl,and is an optional rehabilitation technique for women with SUI.